Laboratory Billing Services
High-volume, low-value claims where clean-claim rate and payer rules decide the margin.
What it covers
- High-volume 837P submission
- CPT and panel-component accuracy
- Medical necessity and LCD/NCD checks
- ABN workflow support
- Client, patient and payer billing splits
- Denial trending by ordering provider and payer
Where practices lose money here
Panel unbundling errors
Billing components separately when a panel code exists is an overpayment exposure; billing the panel when components were not all performed is a denial.
Medical necessity failures
Lab denials cluster hard around diagnosis-to-test linkage. One unlinked ordering habit can generate thousands of denials.
Low claim value, high claim count
At lab volumes, a two-percent clean-claim gap is not a rounding error — it is the margin.
How Medway handles it
- Panel and component logic is validated on every claim, not sampled.
- Diagnosis-to-test linkage is checked against payer LCD/NCD policy before submission.
- Denials are trended by ordering provider so the root cause can be fixed upstream.
- Client, patient and payer splits are kept clean so balances land in the right bucket.
What you get
- Clean-claim rate treated as the primary metric
- Medical-necessity failures caught before submission
- Denial trends fed back to ordering providers
- Billing splits that reconcile
Get a free audit of your laboratory billing claims. Send us a recent aging report and we will show you, in writing, where the recoverable revenue is — no cost, no commitment.
Frequently Asked Questions
You send us a recent accounts receivable aging report and, where possible, a denial export. We review them and give you a written breakdown: where recoverable revenue is sitting, which denial reasons are costing you most, what your timely-filing exposure looks like, and the fixes we would make in priority order. It is yours to keep whether or not you work with us. Please do not include patient health information — we only need claim-level financial data.
Most of the timeline is payer enrollment and EDI setup, and neither is fully in our control — that is the honest answer. Practices already enrolled with their payers typically start seeing claims go out within two to three weeks. Where new enrollments or revalidations are needed, budget longer, because the payer sets that pace. We tell you which of the two you are in after looking at your current setup.
Solo practitioners are often the strongest case for it, not the weakest. A one-person billing office has no redundancy — a vacation or a resignation stops your revenue cycle, and the cost is not the temp, it is the AR that ages and the claims that pass their filing deadline while nobody is working them.
Access to your existing EMR/PMS, your payer list and contracts, your fee schedule, and a recent AR aging report. If you are moving from another biller, we also need clarity on who works the open AR at transition — that is the single most commonly mishandled part of a billing switch.
